Tearsheet

Inspire Medical Systems (INSP)


Market Price (12/4/2025): $135.28 | Market Cap: $4.0 Bil
Sector: Health Care | Industry: Health Care Equipment

Inspire Medical Systems (INSP)


Market Price (12/4/2025): $135.28
Market Cap: $4.0 Bil
Sector: Health Care
Industry: Health Care Equipment

Investment Highlights Why It Matters Which of these 2 stories sounds closer for this stock?

1. Generates cash flow

The stock generated 4% or more of the share price (called cash flow yield), and shows moderate 10-15% or more growth.

2. Riding a trend

Think Tesla during the pandemic of 2020 when EVs were riding a cultural high, or Nvidia in the current AI boom, or even Figma. These companies don’t have enough yield, or, enough growth, or both - however - they are riding a trend. They have momentum. These can be more volatile - they don’t have the floor of strong cash flow


0 Cash is significant % of market cap
Net D/ENet Debt/Equity. Debt net of cash. Negative indicates net cash. Equity is taken as the Market Capitalization is -13%
Weak multi-year price returns
2Y Excs Rtn is -57%, 3Y Excs Rtn is -113%
Expensive valuation multiples
P/EBITPrice/EBIT or Price/(Operating Income) ratio is 47x, P/EPrice/Earnings or Price/(Net Income) is 49x
1 Attractive cash flow generation
CFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is 15%, FCF/Rev LTMFree Cash Flow / Revenue (Sales), Last Twelve Months (LTM) is 11%
Meaningful short interest
Short Interest % of Basic SharesShort Interest % of Basic Shares = (Short Interest Quantity) / (Basic Shares Outstanding). A high fraction of short interest can indicate potential risk of a short squeeze. is 13%
Yield minus risk free rate is negative
ERPEquity Risk Premium (ERP) = Total Yield - Risk Free Rate, Reflects the premium above risk free assets offered by the investment. is -2.1%
2 Valuation becoming less expensive
P/S 6M Chg %Price/Sales change over 6 months. Declining P/S indicates valuation has become less expensive. is -56%
  
3 Megatrend and thematic drivers
Megatrends include Precision Medicine, Digital Health & Telemedicine, and Aging Population & Chronic Disease. Themes include Targeted Therapies, Show more.
  
0 Cash is significant % of market cap
Net D/ENet Debt/Equity. Debt net of cash. Negative indicates net cash. Equity is taken as the Market Capitalization is -13%
1 Attractive cash flow generation
CFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is 15%, FCF/Rev LTMFree Cash Flow / Revenue (Sales), Last Twelve Months (LTM) is 11%
2 Valuation becoming less expensive
P/S 6M Chg %Price/Sales change over 6 months. Declining P/S indicates valuation has become less expensive. is -56%
3 Megatrend and thematic drivers
Megatrends include Precision Medicine, Digital Health & Telemedicine, and Aging Population & Chronic Disease. Themes include Targeted Therapies, Show more.
4 Weak multi-year price returns
2Y Excs Rtn is -57%, 3Y Excs Rtn is -113%
5 Meaningful short interest
Short Interest % of Basic SharesShort Interest % of Basic Shares = (Short Interest Quantity) / (Basic Shares Outstanding). A high fraction of short interest can indicate potential risk of a short squeeze. is 13%
6 Expensive valuation multiples
P/EBITPrice/EBIT or Price/(Operating Income) ratio is 47x, P/EPrice/Earnings or Price/(Net Income) is 49x
7 Yield minus risk free rate is negative
ERPEquity Risk Premium (ERP) = Total Yield - Risk Free Rate, Reflects the premium above risk free assets offered by the investment. is -2.1%

Valuation, Metrics & Events

INSP Stock


Why The Stock Moved


Qualitative Assessment

AI Generated Analysis | Feedback

The requested time period for the stock movement analysis, from August 31, 2025, to December 4, 2025, falls entirely within the future from the current processing date. Analyzing historical stock performance and identifying key causal factors for a period that has not yet occurred is not possible. However, the search results provide some information about events occurring around and within this future period, as reported on December 3-4, 2025. This indicates that there are reports discussing events that *are said to have occurred* in the period leading up to or around the specified future date within the context of the search results. Specifically, there are discussions about events that *allegedly* occurred in August 2025. I will synthesize these provided events as they are presented in the search results, even though they are presented from the perspective of December 2025 looking back at earlier 2025 events. Here are key points related to Inspire Medical Systems (INSP) from the provided information: **1. Inspire V Launch Setbacks and Reduced Guidance:** Inspire Medical Systems faced significant issues with the launch of its Inspire V neurostimulation system. On August 4, 2025, the company disclosed that the Inspire V launch was experiencing an "elongated timeframe" due to factors such as many treatment centers not completing required training, contracting, and onboarding criteria. This led to a dramatic reduction in its 2025 earnings per share guidance by over 80%. **2. Stock Price Decline Following Launch News:** Following the announcement of the Inspire V launch setbacks on August 4, 2025, Inspire's stock price plummeted by more than 32%, dropping from $129.95 per share to $87.91 per share by August 5, 2025. This translated to approximately $1.2 billion in market capitalization loss. **3. Securities Fraud Lawsuits:** Multiple securities class-action lawsuits were filed against Inspire Medical Systems, Inc. and its executives. These lawsuits allege that the company misled investors about its preparedness for the Inspire V launch, concealing issues such as poor demand, excess inventory of older devices, and failures in billing software updates that affected reimbursement. Investors have until January 5, 2026, to seek to be appointed lead plaintiff. **4. Positive Momentum from Medicare Reimbursement Boost:** Despite earlier challenges, Inspire Medical Systems experienced a positive stock movement in late November/early December 2025, with shares trading higher (e.g., 7% higher on December 3, 2025, and jumping 5.3% on December 2, 2025) after the Centers for Medicare & Medicaid Services (CMS) finalized a significant increase in reimbursement rates for Inspire's sleep apnea procedures, effective in 2026. This 50% increase in Medicare reimbursement, from approximately $30,000 to $45,000 per procedure, is expected to boost procedure adoption and address margin pressure. **5. Analyst Rating Changes and Price Target Adjustments:** Analysts adjusted their ratings and price targets for INSP shares during this period. For example, in October and November 2025, some analysts decreased target prices, while others, like Wells Fargo & Company, upgraded the stock from "equal weight" to "overweight" in early November. Morgan Stanley raised its price target to $130 from $105 in December 2025. Following the Medicare reimbursement news, Wolfe Research upgraded the stock to Outperform with a $180 price target.

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Stock Movement Drivers

Return vs. Risk


Price Returns Compared

 202020212022202320242025Total [1]
Returns
INSP Return153%22%9%-19%-9%-28%80%
Peers Return48%7%-18%-29%48%-12%20%
S&P 500 Return16%27%-19%24%23%16%112%

Monthly Win Rates [3]
INSP Win Rate83%58%58%50%50%10% 
Peers Win Rate56%44%52%48%50%40% 
S&P 500 Win Rate58%75%42%67%75%70% 

Max Drawdowns [4]
INSP Max Drawdown-44%-12%-36%-50%-38%-61% 
Peers Max Drawdown-26%-22%-43%-48%-18%-31% 
S&P 500 Max Drawdown-31%-1%-25%-1%-2%-15% 


[1] Cumulative total returns since the beginning of 2020
[2] Peers: GMED, PEN, MASI, NVCR, DAVI.
[3] Win Rate = % of calendar months in which monthly returns were positive
[4] Max drawdown represents maximum peak-to-trough decline within a year
[5] 2025 data is for the year up to 12/3/2025 (YTD)

How Low Can It Go

Unique KeyEventINSPS&P 500
2022 Inflation Shock2022 Inflation Shock  
2022 Inflation Shock% Loss% Loss-61.6%-25.4%
2022 Inflation Shock% Gain to Breakeven% Gain to Breakeven160.3%34.1%
2022 Inflation ShockTime to BreakevenTime to BreakevenNot Fully Recovered days464 days
2020 Covid Pandemic2020 Covid Pandemic  
2020 Covid Pandemic% Loss% Loss-53.7%-33.9%
2020 Covid Pandemic% Gain to Breakeven% Gain to Breakeven116.0%51.3%
2020 Covid PandemicTime to BreakevenTime to Breakeven86 days148 days
2018 Correction2018 Correction  
2018 Correction% Loss% Loss-35.0%-19.8%
2018 Correction% Gain to Breakeven% Gain to Breakeven53.7%24.7%
2018 CorrectionTime to BreakevenTime to Breakeven63 days120 days

Compare to GMED, PEN, MASI, NVCR, DAVI


In The Past

Inspire Medical Systems's stock fell -61.6% during the 2022 Inflation Shock from a high on 7/14/2023. A -61.6% loss requires a 160.3% gain to breakeven.

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About Inspire Medical Systems (INSP)

Better Bets than Inspire Medical Systems (INSP)

Latest Trefis Analyses

Trade Ideas

Select past ideas related to INSP. For more, see Trefis Trade Ideas.

Unique KeyDateTickerCompanyCategoryTrade Strategy6M Fwd Rtn12M Fwd Rtn12M Max DD
CRL_11142025_Dip_Buyer_FCFYield11142025CRLCharles River Laboratories InternationalDip BuyDB | FCFY OPMDip Buy with High FCF Yield and High Margin
Buying dips for companies with high FCF yield and meaningfully high operating margin
4.1%4.1%-3.7%
GDRX_11142025_Dip_Buyer_High_CFO_Margins_ExInd_DE11142025GDRXGoodRxDip BuyDB | CFO/Rev | Low D/EDip Buy with High Cash Flow Margins
Buying dips for companies with significant cash flows from operations and reasonable debt / market cap
-9.8%-9.8%-11.8%
ASTH_11142025_Dip_Buyer_High_FCF_Yield_ExInd_DE_RevG11142025ASTHAstrana HealthDip BuyDB | FCF Yield | Low D/EDip Buy with High Free Cash Flow Yield
Buying dips for companies with significant free cash flow yield (FCF / Market Cap) and reasonable debt / market cap
6.0%6.0%-5.5%
SGRY_11142025_Dip_Buyer_High_FCF_Yield_ExInd_DE_RevG11142025SGRYSurgery PartnersDip BuyDB | FCF Yield | Low D/EDip Buy with High Free Cash Flow Yield
Buying dips for companies with significant free cash flow yield (FCF / Market Cap) and reasonable debt / market cap
9.7%9.7%-1.4%
TFX_11072025_Dip_Buyer_FCFYield11072025TFXTeleflexDip BuyDB | FCFY OPMDip Buy with High FCF Yield and High Margin
Buying dips for companies with high FCF yield and meaningfully high operating margin
6.2%6.2%-5.1%
Unique KeyDateTickerCompanyCategoryTrade Strategy6M Fwd Rtn12M Fwd Rtn12M Max DD
CRL_11142025_Dip_Buyer_FCFYield11142025CRLCharles River Laboratories InternationalDip BuyDB | FCFY OPMDip Buy with High FCF Yield and High Margin
Buying dips for companies with high FCF yield and meaningfully high operating margin
4.1%4.1%-3.7%
GDRX_11142025_Dip_Buyer_High_CFO_Margins_ExInd_DE11142025GDRXGoodRxDip BuyDB | CFO/Rev | Low D/EDip Buy with High Cash Flow Margins
Buying dips for companies with significant cash flows from operations and reasonable debt / market cap
-9.8%-9.8%-11.8%
ASTH_11142025_Dip_Buyer_High_FCF_Yield_ExInd_DE_RevG11142025ASTHAstrana HealthDip BuyDB | FCF Yield | Low D/EDip Buy with High Free Cash Flow Yield
Buying dips for companies with significant free cash flow yield (FCF / Market Cap) and reasonable debt / market cap
6.0%6.0%-5.5%
SGRY_11142025_Dip_Buyer_High_FCF_Yield_ExInd_DE_RevG11142025SGRYSurgery PartnersDip BuyDB | FCF Yield | Low D/EDip Buy with High Free Cash Flow Yield
Buying dips for companies with significant free cash flow yield (FCF / Market Cap) and reasonable debt / market cap
9.7%9.7%-1.4%
TFX_11072025_Dip_Buyer_FCFYield11072025TFXTeleflexDip BuyDB | FCFY OPMDip Buy with High FCF Yield and High Margin
Buying dips for companies with high FCF yield and meaningfully high operating margin
6.2%6.2%-5.1%

Recent Active Movers

Recent Active Movers

More From Trefis

Peer Comparisons for Inspire Medical Systems

Peers to compare with:

Financials

INSPGMEDPENMASINVCRDAVIMedian
NameInspire .Globus M.Penumbra Masimo NovoCure Davion H. 
Mkt Price134.7587.75285.71138.0911.81-134.75
Mkt Cap4.011.811.27.51.3-7.5
Rev LTM8832,7701,3342,182642-1,334
Op Inc LTM37434173133-177-133
FCF LTM99570153168-65-153
FCF 3Y Avg4833111193-78-93
CFO LTM134715203208-34-203
CFO 3Y Avg80444140147-45-140

Growth & Margins

INSPGMEDPENMASINVCRDAVIMedian
NameInspire .Globus M.Penumbra Masimo NovoCure Davion H. 
Rev Chg LTM16.8%11.7%14.6%38.5%11.2%-14.6%
Rev Chg 3Y Avg37.7%45.6%17.2%11.4%6.2%-17.2%
Rev Chg Q10.5%22.9%17.8%8.2%7.8%-10.5%
QoQ Delta Rev Chg LTM2.5%5.5%4.2%1.3%1.9%-2.5%
Op Mgn LTM4.2%15.7%13.0%6.1%-27.5%-6.1%
Op Mgn 3Y Avg-0.9%13.9%8.6%8.9%-33.2%-8.6%
QoQ Delta Op Mgn LTM-0.6%2.4%0.5%2.0%-0.1%-0.5%
CFO/Rev LTM15.1%25.8%15.2%9.5%-5.4%-15.1%
CFO/Rev 3Y Avg10.1%19.7%11.6%8.1%-8.1%-10.1%
FCF/Rev LTM11.2%20.6%11.4%7.7%-10.1%-11.2%
FCF/Rev 3Y Avg5.9%14.3%9.2%5.3%-13.8%-5.9%

Valuation

INSPGMEDPENMASINVCRDAVIMedian
NameInspire .Globus M.Penumbra Masimo NovoCure Davion H. 
Mkt Cap4.011.811.27.51.3-7.5
P/S2.52.87.43.72.3-2.8
P/EBIT46.917.852.9-46.7-11.4-17.8
P/E48.818.260.4-14.0-8.1-18.2
P/CFO16.310.848.738.3-41.9-16.3
Total Yield2.0%5.5%1.7%-7.1%-12.3%-1.7%
Dividend Yield0.0%0.0%0.0%0.0%0.0%-0.0%
FCF Yield 3Y Avg1.8%4.2%1.3%1.1%-4.8%-1.3%
D/E0.00.00.00.10.6-0.0
Net D/E-0.1-0.0-0.00.0-0.2--0.0

Returns

INSPGMEDPENMASINVCRDAVIMedian
NameInspire .Globus M.Penumbra Masimo NovoCure Davion H. 
1M Rtn82.8%43.4%26.3%-4.7%-3.4%-26.3%
3M Rtn57.4%49.2%5.9%1.0%-2.2%-5.9%
6M Rtn-2.3%47.1%11.9%-15.3%-29.4%--2.3%
12M Rtn-29.8%3.1%16.5%-20.7%-61.3%--20.7%
3Y Rtn-43.7%17.1%35.5%-5.1%-85.2%--5.1%
1M Excs Rtn82.8%43.4%26.3%-4.7%-3.4%-26.3%
3M Excs Rtn50.8%40.2%-3.2%-8.8%-6.8%--3.2%
6M Excs Rtn-17.0%32.4%-2.8%-30.0%-44.1%--17.0%
12M Excs Rtn-43.6%-11.0%3.5%-33.5%-54.6%--33.5%
3Y Excs Rtn-113.2%-49.3%-28.5%-75.5%-155.9%--75.5%

Financials

Segment Financials

Revenue by Segment

$ Mil20242023202220212020
Single Segment62540823311582
Total62540823311582


Price Behavior

Short Interest

Short Interest: As Of Date11142025
Short Interest: Shares Quantity3,671,015
Short Interest: % Change Since 1031202511.1%
Average Daily Volume1,502,849
Days-to-Cover Short Interest2.44
Basic Shares Quantity29,332,376
Short % of Basic Shares12.5%

SEC Filings

Expand for More

Report DateFiling DateFiling
93020251103202510-Q 9/30/2025
6302025804202510-Q 6/30/2025
3312025505202510-Q 3/31/2025
12312024210202510-K 12/31/2024
93020241104202410-Q 9/30/2024
6302024806202410-Q 6/30/2024
3312024507202410-Q 3/31/2024
12312023209202410-K 12/31/2023
93020231107202310-Q 9/30/2023
6302023801202310-Q 6/30/2023
3312023502202310-Q 3/31/2023
12312022210202310-K 12/31/2022
93020221101202210-Q 9/30/2022
6302022802202210-Q 6/30/2022
3312022503202210-Q 3/31/2022
12312021215202210-K 12/31/2021